Claim total
$1,396.14
base $155.66 · payer covered $1,346.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-11-07
- Stop
- 2022-11-07
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-050b-51cf5cb1042d